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Shoulder: Thoracic Outlet Syndrome

My hands, especially my little fingers, go numb (they tingle), whenever I climb a lot. A few pulls here or there cause no problem, but all-day climbing sure does. It seems related to my shoulders or even neck, as it’s worse when I carry a heavy pack or gear sling.

Duane Raleigh, Redstone, Colorado

Homie, you have thoracic outlet syndrome. There are other ways of attaining the lofty medical heights of numb appendages, but this is the most likely explanation. The nerves that arise from your neck and feed into your arm are getting pinched, most likely in the side of your neck, or between your collar bone and first rib. Any therapist worth a grain of salt will know what to do. That said, salt can be an amazingly rare commodity in the medical field.

You need a solid massage and a jolly good cracking in your upper thoracic and lower cervical spine (upper back and lower neck). A physical therapist will do the soft tissue only, unless you can find one that does manipulations as well. A chiro will do manipulations but is highly unlikely to spend any time doing the soft-tissue component. If either of these therapists does both, sweet. An osteopath of the musculo-skeletal variety will almost certainly do both, but you will pay more. Most doctors of osteopathy in the States operate a bit like holistic family doctors. You will need to call and ask if the person’s practice is more about manual therapy than general medicine. Any practitioner consulting for less than 10 minutes is massaging your wallet. Twenty to 30 minutes is worth paying for. A good therapist will give you a bunch of stretches to do. Yoga is your friend! Stress is your enemy. Peace and love and a happy world—problem solved. May you meditate full throttle, no parachute. Lovely.

P.S. I am not too sure what meditation is, as my nose always gets itchy, and apparently, you are supposed to ignore it, which I can’t.